The United States Chiropractic Workforce: An alternative or complement to primary care?

UnlabelledBackgroundIn the United States (US) a shortage of primary care physicians has become evident. Other health care providers such as chiropractors might help address some of the nation's primary care needs simply by being located in areas of lesser primary care resources. Therefore, the purpose of this study was to examine the distribution of the chiropractic workforce across the country and compare it to that of primary care physicians.MethodsWe used nationally representative data to estimate the per 100,000 capita supply of chiropractors and primary care physicians according to the 306 predefined Hospital Referral Regions. Multiple variable Poisson regression was used to examine the influence of population characteristics on the supply of both practitioner-types.ResultsAccording to these data, there are 74,623 US chiropractors and the per capita supply of chiropractors varies more than 10-fold across the nation. Chiropractors practice in areas with greater supply of primary care physicians (Pearson's correlation 0.17, p-value < 0.001) and appear to be more responsive to market conditions (i.e. more heavily influenced by population characteristics) in regards to practice location than primary care physicians.ConclusionThese findings suggest that chiropractors practice in areas of greater primary care physician supply. Therefore chiropractors may be functioning in more complementary roles to primary care as opposed to an alternative point of access

Identification Using Russell 1000/2000 Index Assignments: A Discussion of Methodologies

This paper discusses tradeoffs of various empirical methods used in recent papers that rely on Russell 1000/2000 index assignments for identification. The paper also addresses why different approaches to this identification appear to reach different conclusions about the effect of index assignment on firm’s ownership structure and corporate policies

Passive Investors, Not Passive Owners

Passive institutional investors are an increasingly important component of U.S. stock ownership. To examine whether and by which mechanisms passive investors influence firms\u27 governance, we exploit variation in ownership by passive mutual funds associated with stock assignments to the Russell 1000 and 2000 indexes. Our findings suggest that passive mutual funds influence firms\u27 governance choices, resulting in more independent directors, removal of takeover defenses, and more equal voting rights. Passive investors appear to exert influence through their large voting blocs, and consistent with the observed governance differences increasing firm value, passive ownership is associated with improvements in firms’ longer-term performance

Photon number resolving detection using time-multiplexing

Detectors that can resolve photon number are needed in many quantum information technologies. In order to be useful in quantum information processing, such detectors should be simple, easy to use, and be scalable to resolve any number of photons, as the application may require great portability such as in quantum cryptography. Here we describe the construction of a time-multiplexed detector, which uses a pair of standard avalanche photodiodes operated in Geiger mode. The detection technique is analysed theoretically and tested experimentally using a pulsed source of weak coherent light.Comment: 20 pages, 14 figures, accepted to Journal of Modern Optic

The United States Chiropractic Workforce: An alternative or complement to primary care?

UnlabelledBackgroundIn the United States (US) a shortage of primary care physicians has become evident. Other health care providers such as chiropractors might help address some of the nation's primary care needs simply by being located in areas of lesser primary care resources. Therefore, the purpose of this study was to examine the distribution of the chiropractic workforce across the country and compare it to that of primary care physicians.MethodsWe used nationally representative data to estimate the per 100,000 capita supply of chiropractors and primary care physicians according to the 306 predefined Hospital Referral Regions. Multiple variable Poisson regression was used to examine the influence of population characteristics on the supply of both practitioner-types.ResultsAccording to these data, there are 74,623 US chiropractors and the per capita supply of chiropractors varies more than 10-fold across the nation. Chiropractors practice in areas with greater supply of primary care physicians (Pearson's correlation 0.17, p-value < 0.001) and appear to be more responsive to market conditions (i.e. more heavily influenced by population characteristics) in regards to practice location than primary care physicians.ConclusionThese findings suggest that chiropractors practice in areas of greater primary care physician supply. Therefore chiropractors may be functioning in more complementary roles to primary care as opposed to an alternative point of access

An exploration of the effectiveness of artificial mini-magnetospheres as a potential solar storm shelter for long term human space missions

If mankind is to explore the solar system beyond the confines of our Earth and Moon the problem of radiation protection must be addressed. Galactic cosmic rays and highly variable energetic solar particles are an ever-present hazard in interplanetary space. Electric and/or magnetic fields have been suggested as deflection shields in the past, but these treated space as an empty vacuum. In fact it is not empty. Space contains a plasma known as the solar wind; a constant flow of protons and electrons coming from the Sun. In this paper we explore the effectiveness of a “mini-magnetosphere” acting as a radiation protection shield. We explicitly include the plasma physics necessary to account for the solar wind and its induced effects. We show that, by capturing/containing this plasma, we enhance the effectiveness of the shield. Further evidence to support our conclusions can be obtained from studying naturally occurring “mini-magnetospheres” on the Moon. These magnetic anomalies (related to “lunar swirls”) exhibit many of the effects seen in laboratory experiments and computer simulations. If shown to be feasible, this technology could become the gateway to manned exploration of interplanetary space

Miniature Low-Noise G-Band I-Q Receiver

Weather forecasting, hurricane tracking, and atmospheric science applications depend on humidity sounding of atmosphere. Current instruments provide these measurements from groundbased, airborne, and low Earth orbit (LEO) satellites by measuring radiometric temperature on the flanks of the 183-GHz water vapor line. Miniature, low-noise receivers have been designed that will enable these measurements from a geostationary, thinned array sounder, which is based on hundreds of low-noise receivers that convert the 180-GHz signal directly to baseband in-phase and in-quadrature signals for digitization and correlation. The developed receivers provide a noise temperature of 450 K from 165 to 183 GHz (NF = 4.1 dB), and have a mass of 3 g while consuming 24 mW of power. These are the most sensitive broadband I-Q receivers at this frequency range that operate at room temperature, and are significantly lower in mass and power consumption than previously reported receivers

High resolution sequencing of hepatitis C virus reveals limited intra-hepatic compartmentalization in end-stage liver disease

Background & Aims The high replication and mutation rate of hepatitis C virus (HCV) results in a heterogeneous population of viral sequences in vivo. HCV replicates in the liver and infected hepatocytes occur as foci surrounded by uninfected cells that may promote compartmentalization of viral variants. Given recent reports showing interferon stimulated gene (ISG) expression in chronic hepatitis C, we hypothesized that local interferon responses may limit HCV replication and evolution. Methods To investigate the spatial influence of liver architecture on viral replication we measured HCV RNA and ISG mRNA from each of the 8 Couinaud segments of the liver from 21 patients undergoing liver transplant. Results HCV RNA and ISG mRNA levels were comparable across all sites from an individual liver but showed up to 500-fold difference between patients. Importantly, there was no association between ISG and HCV RNA expression across all sites in the liver or plasma. Deep sequencing of HCV RNA isolated from the 8 hepatic sites from two subjects showed a similar distribution of viral quasispecies across the liver and uniform sequence diversity. Single genome amplification of HCV E1E2-envelope clones from 6 selected patients at 2 hepatic sites supported these data and showed no evidence for HCV compartmentalization. Conclusions We found no differences between the hepatic and plasma viral quasispecies in all patients sampled. We conclude that in end-stage liver disease HCV RNA levels and the genetic pool of HCV envelope sequences are indistinguishable between distant sites in the liver and plasma, arguing against viral compartmentalization